Application for Leave

Please complete the form to explain your son's absence.
  • 5 Character code eg. 07SURA, 12RICB
  • Date Format: MM slash DD slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
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  • Parent Declaration

    As the parent of the above mentioned student, I hereby apply for a Certificate of Exemption from attendance at school, under the Education Act 1990. I understand that if the exemption is granted: - I am responsible for his/her supervision during the period of exemption - the exemption is limited to the period indicated - the exemption is subject to the conditions listed on the Certificate of Exemption - the exemption may be cancelled at any time. I declare the information provided in this application for a certificate of exemption is to the best of my knowledge and belief accurate and complete. I recognise that should statements in this application later prove to be false or misleading any decision made as a result of this application may be reversed. I further recognise that a failure to comply with any condition set out in the exemption may result in the exemption being revoked.
  • Note - long term exemptions

    Where the reason for application for exemption includes long term travel arrangements of more than 20 school days, copies of travel documentation is to be included with the application.
  • Prior/Current Exemptions (if applicable)

    The following ONLY applies to students who have previously applied for leave or have a current leave application in place.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
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  • This field is for validation purposes and should be left unchanged.